Loading...
HomeMy WebLinkAbout021-134-00321-134-03 { VICKIE HORN _ 1302 Block Rd, Gridley Contr:. Meyers Roofing Permit#1555-84B(aew-roof/SF) 02'1'-13-4-003 9270107 r HORN, RICHARD CONTR:' OWNER 1 302 ,BLOCK RD, GR'I DLEY , R; ELEC ;SERV/SF 4 1 ! a f •r �„T..��„..-„y...,.z,,. '«r aF,.,�trgr°�'.. k, Y4Mf� Jy�+ .]t�+'t'S-vKt.'t+•",�W-' °Z1�71_ <U ' =.51..-`s.t••. ' r`.. ., ';�j. ,��� • .; .. ..I�YAatA+�(�'�faH�w�ik” `. • i .R 021- � 3-4 -003 ,1; ` HORN, RICHARD 92-01.07 CONTR . OWNER .. .' 1302 BLOCK RD,-. GRIDLEY ELEC SERV/SF ... � l%am/ i , �, - , r , .tea• - ' i` OFFICE COPY M ; � 'xl 1y OM1• A • •'� r 1 y , i� •.r� k ' � v 4 J Address kyf r GAS --- —_— '_`— J�f� Meter^By' Dates..ELECTRIC ' ' Dat } Meter By j' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllie, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N0. 9 Z ASSESSeOA _� RC L NUMBER 021-134-003 ZONING BUILDING PERMIT OWNER nT�7+�j� (y��v RICHARD HORN TELEPHONE 84"512 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1302 BIM ROAD GRIMU 95948 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION N[`'�''L��ENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER NM LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 13172 BIM ROAD GRIDLEY Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 rt-vy USE OF STRUCTURE SFEN Duplex❑ Mobilehome❑ Other SPECIFY # Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I 13 I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities[:; Installation ❑ ther ❑ Describe work:_UPGRIME SERVICCR 'M 7()[) AMP Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 18.50 • 50 200A OR LESS Main service 200ATO1000AI CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑I am licensed under p provisions Of Cha t. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason _37.50 NEW CONST. DWELLING OCCUP.& 3.64sq.ft. OR ADDNS. AC UL I -OU NEW CONSTR.ULTI.OUT LET @ 5.00 NON-RESID BRANCH CIRC ITS (POWER APPARATUS e %SINGLE OUTLET CIR. EX. OCCU 20 76 p OUTLETS OR FIXTURES FIXED EX. OCCUp. OUTLETS P(RESID.)REA.Y I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 15,00 PRE• Permit Fee $ W • — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject Ia to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against -said County in consequence of the granting of this permit. X;�;5 -�;-s-�►-c Date % % Si nature of Applicant — Owner 9 pP Q- Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE I TOTAL FEE $ 68.50 HAz I DFEES IMP I FLOOD I CDF PARCEL I Po HD s� This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above)for which fees have been paid. /DFRECfQft OF PUBLIC WORKS By ? ` ` . — Date 111_7110vReceipt PE� EXPIRES Date / ' No. 103763 WHITE-D.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR, GOLDENROD -APPLICANT _�L� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT__9 ;?–, PERMIT NO. ASSESSOR PARCEL NUMBER 021-134-003 ZONING 1 BUILDING PERMIT xl* OWNER RICHARD HORN TELEPHONE r 846,-4512 SO. FT. OCC. BUILDING VALUATI N OWNER'S MAILING ADDRESS 1302 BLOCK ROAD GRIDLEY 95948 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Ener Plan Checking Energy g Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1302BLOCK ROAD GRIDLEY Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF EX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home IS G W 615.00 TYPE OF WORK New❑ Addition [I Remodel❑ Utilities[ Installation❑ Other ❑ Describe work: _ITP(, AT)1. 4$RVIr..F TQ 900 AMP _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 18.50 Main service 200ATO1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUPM 3.64 sq.ft. DR ACDNS, l ACC. BLDGS. NEW CONSTR.MULTI-OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e SINGLE OUTLET CIR. EX. OCCUpo 120076 UTLETS OR FIXTURES FIXED APLINISLicense EX. OCCup. OUTLETS PIRESI D.)RE A,� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 PRE–INSP 20.00 Permit Fee $ 68.50 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department of Consent to Self -Insure. a Certificate of Workmen's Compensation Insurance or a CertificateEJ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue ZagaoiZ,nk�nn equence of the granting of this permit. �z Date _C % % Is Signature of Applicant — Owner /Contractor El ❑ An OSHA ions over 5'0" deep and demolition or construct- ion of structures tover 3Qstories oin excavations Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAz DFEES IMP ROOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi sions of the Butte County Code and/or resolution to do work indic d abo for which fees have been paid. � OF PUBLIC WORKS By ate PER IT EXPIRES Date /7 9� Receipt No. 1763 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r'�*v">�o�}�..#!Y�:cEirtY t`t�r�sv�;�t-�.n'i`•�+t°�t.4''`�';r�•.'kr��"`�i�a�`."'���"��.'�'^'�; COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILL'�E;}.CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APF01C'ATION DATASHEET J Permit No.� OWNER fit r, 14 6 r4 �(D �' 0'I Proposed Building Use r' �G Building Inspector Date ` �S At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ............ 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......:.. 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban.Area fees paid ....................................... 12. Park fees paid .................................................... 13• School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW' - 7/119. Driveway permit (constryrtjon approval required prior to occupancy) 20. Pre -Inspection for S°� (Rrf r i o required Pre-Inspec. recLyest 13uilding`Inspector `��/ 7-y(Date) 21. Contractor's license information (No., 'Name Style, Classifications .: �6 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner o) ..... 24. Recorded co •"'"` py of Agricultural Acknowledgment Statement .........-- 25. Letter of signature authorization ...................................""' 26. 27. When you issue the permit, process as follows: Mail to owner. Mail .to contractor. Telephone and hold for p ckup at office. Deliver w/inspector. Other AppI icant -' Date Copy of Hdz-Mat form sent Health Dept. Fire Dept. air Pollution Date Copy of plans sent Health Dept.. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_maiI—counter by _date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by Sets of plans on hold in File cabinet AP folder Copy—DPW e COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.`538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER _ 3 V -D03 yONING BUILDING PERMIT t, VJTELEPHONE O WNEr /16 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILI G ADO ESS Ad 0 �, )� ^ l/ CONTRACTOR'S NAME I ow nor TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace STaluation Oki CONUCTION LENDER UNKNOWN Total V $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHIT CT O�}R ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS B1o�� n Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.001. Solar or heat pump water heater 1 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF r9t Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 Building sewer 15.00 Mobile Home I S I G JW I @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lit'(� Installation ❑ Other ❑ Describe work: h s - U 1,C_6 +0 U J00 W Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 If Main service 600VORLESS 200A OR LESS 18.50 Main service 20GATO 1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License .Jo. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason OCCUP.,I) NEW CONST. DWELLING OR ADONS. ( ACC. SLOGS. I 3.6¢sq.ft. NEW CONSTFLMULTI-OUTLET NON.RESID BRANCH CIRC ITS @ 5 00 POWER APPARATUS o- (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES L760 0 460 FIXED Ex. Occup. OUTLETS P(RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 r - J40, 00 _Ln5p Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g Hood 6.50 ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Si nature of Applicant - Owner g pp ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct - ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST TYPE TO L FEES G HAz I DFEES I IMP I FLOOD CDF I PARCEL PO HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. ,� %(Oin/_13 WHITE-O.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR, GOLD ENROD-APPL I CANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 959.65 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) i/ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. )I plan to provide portions of this work, but I have hired the following person ' to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: . Name Address . Phone Type of Work Signed: Property Owner Socialm rit Number / Date �_i NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. PRE -INSPECTION A,C4,2 Z/�G7OWNER: rd //o © r Vl _ DATE J~ LOCATION : moc�©C(� r r ICSv A. P. # CONTRACTOR: ( wt26 ►'' ZONING PRE -INSPECTION FOR: (/C r g g l (,J r i C SeL 'n V i L(L _� U d o �m DATE TO INSPECTOR 1, PERMIT HISTORY: NONE [ AS FOLLOWS: gorocT TYPE OF OCCUPANCY 5):: -- FIELD - INFORMATION BUILDING USAGE: 5 TENNANT: l2foCCUPIED E21/ HAS ELECTRIC HAS GAS 5JHAS SANITATION FACILITIES L2 1 HEATED -COOLED PERSON CONTACTED_M OTHER COMMENTS: ACTIO 1 RECOMMENDED: ISSUE OTHER: 0 HOLD FOR Permit#1555-84 Vickie Horn COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE ,SQ. FT. OCC. BUILDING VAL�}UATION ' OWNER'S MAILING ADDRESS LIIJv V" CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING A r R SS - "r- h Fireplace CONSTRUCTION LENDER - UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ + ARCHITECT OR ENGINEER '-I'- LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ Z -C 1 BUILDING ADDRESS + , ,. / - I " PLUMBING PERMIT Fili Fee 10.00 n9 ~ Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF [2 Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti Iities ❑ Installation ❑ Other Q Describe work:—"'; ' �'�+ �u• - - - . i.J Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 0V O Main service 100 AMP ORSLESS 10.00 Main service EA. ADD -L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 1 2/20sgff CONTRACTORS LICENSE LAW underenalt perjury penalty of p er i y (check one): I declare 13 'IF I am licensed under provisions of Chapt. 9, Div. 3 of the Business m license is in full force and effect. and Professions Code aY License No. 1 ! '� Classification •' El I. as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR.U TI.OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS NEW CONSTR. / POWER APPARATUS &' NON-RESID. \SINGLE OUTLET CIR. Ex / 20e50t P\OUTLETS OR FIXTURES SALO 30 . Occu_nd FIXED APPLNS, OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X1��� _ ' -� -V I/"� �: Date Signarture of Applicant — Owner ❑ Contractor ❑ Agent Q An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST, PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC { !/ BY G ``, �J' '/'� PERMIT EXPIRES Date I the applicable provi- resolutions to do fees have been paid. WORKS _ Date°{� ' Receipt No. -_ ���^ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 J� APPLICATION AND PERMIT ASSESSORIPA=CE NUMBER 03BUILDING ZONIIAG- PERMIT OWNER TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION 19/ OWNER'S MAILING AD RESS i CONT A OR'S NAM TE4,EPVONE 69 zfQ CONTR CTq R'S MAILING S OFireplace CONSTRUCTION. LENDERNKNOWN Total Valuation $ FilingFee $ 10'00 LENDER'S MAILING ADDRESS Permit Fee $ 25, ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 3 Q-_ BUILDING ADDRESS 1-7 o _ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home I S1 G W ".00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other 1� Describe work: —2=6 � Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 00v OR LESS 1 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.// DWELLING OCCUP.& OR ADDNS. C ACC. BLDGS. 2/20sgit CONTRACTORS LICENSE LAW I declare -under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No.1�� A �- /� Classification C —H ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST R., U TI.OUTLET 2,50 ea NON-RESID BRANCH CIRC TS. NEW CONSTR. ( POWER APPARATUS W) NON-RESI D. SINGLE OUTLET CIR. 20@50C Ex . Occup(o XED Ts OR FIXTURES BAL®90 FIXED APP LNS. OR EX. Occup. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to* save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against aid un in c sequence of the granting of this permit. 1 �j %� Date ' /"� Sign Lure of Applicant — Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct -CT ion of structures ovper� 3astories in height. Mobile Home Installation Fee $ ' !M TOTAL PERMIT FEE $ Vv OCCUP, GROUP I TYPE DP CONST. PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which R OF PUBLIC BY% ^ PERMIT EXPIRES ate _ ' the applicable provi- resolutions to do fees have been paid. WORKS �.L Date / Receipt No. 1 O cJ 76- WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT